基层医院医务人员HIV职业暴露与防护

发布时间：2018-08-28 08:45

【摘要】：目的 HIV的流行在中国已从高危人群向普通人群扩展，随着HIV感染者或AIDS患者越来越多地出现在基层医疗机构，医务人员在诊疗过程中接触HIV感染者的机会也随之增加，对HIV的职业暴露问题日趋严重。通过调查了解太仓市第一人民医院医务工作者在HIV职业暴露防护中存的问题，分析其主要原因及其影响因素，提出改善建议，以提高基层医院医务人员对HIV职业暴露防护的认识，减少诊疗过程中的HIV职业暴露，从而提高医疗护理质量。方法通过回顾法了解太仓市第一人民医院2010-2013年HIV阳性患者接诊和2013年职业暴露情况，以及对2起HIV职业暴露及应急处理情况和1例HIV确诊阳性患者手术中采取的有效防护措施。结合自行设计问卷调查，用EXCEL建立数据库，生成柱状图和饼状图等，用SPSS18.0进行统计分析，主要运用描述性方法进行分析。结果 1太仓市第一人民医院2010-2013年间接诊48位初筛阳性患者，经苏州市疾病预防控制中心确诊16位，其中出现2起HIV初筛阳性患者的职业暴露。 2通过对2013年职业暴露分析，医务人员职业暴露上报主要以利器伤为主，工作三年内护理人员为高危人群。 3结合调查问卷分析医务人员主观上存在对职业暴露危险性认识不足、标准预防措施不到位等问题，特别对HIV初筛阳性病人管理仍存在漏洞。结论基层医院存在HIV职业暴露风险，职业暴露主要以预防利器伤为主，，工作三年内护理人员为高危人群。通过建立、健全各项HIV防护制度、措施、流程，并有效落实，特别加强对高危人群在HIV患者手术中的防护将可有效降低基层医务人员HIV职业暴露风险。
[Abstract]:Objective the prevalence of HIV has expanded from high-risk population to general population in China. With the increasing emergence of HIV infected persons or AIDS patients in primary health care institutions, The chance of medical staff contact with HIV infection increases in the course of diagnosis and treatment, and the problem of occupational exposure to HIV becomes more and more serious. By investigating the problems of medical workers in the first people's Hospital of Taicang City in HIV occupational exposure protection, the main causes and influencing factors are analyzed, and suggestions for improvement are put forward. In order to improve the understanding of HIV occupational exposure protection and reduce the HIV occupational exposure in the course of diagnosis and treatment, the medical staff can improve the quality of medical care. Methods the data of HIV positive patients in Taicang first people's Hospital from 2010 to 2013 and occupational exposure in 2013 were analyzed retrospectively. Two cases of occupational exposure and emergency management of HIV and one case of HIV positive patients were treated with effective protective measures. In combination with the self-designed questionnaire, the database is built with EXCEL, the histogram and pie chart are generated, and the statistical analysis is carried out by SPSS18.0, mainly by descriptive method. Results 1 the first people's Hospital of Taicang City received 48 primary screening positive patients from 2010 to 2013, 16 of whom were confirmed by the Suzhou Center for Disease Control and Prevention. Among them, there were 2 occupational exposures of HIV positive patients. 2 through the analysis of occupational exposures in 2013, medical workers' occupational exposures were mainly reported as sharp injuries. Nurses were high risk groups within three years of work. 3 combined with questionnaire analysis, medical staff had some problems, such as insufficient understanding of occupational exposure risk, inadequate standard prevention measures, and so on. In particular, there are still loopholes in the management of HIV positive patients. Conclusion there is occupational exposure risk of HIV in primary hospital. The occupational exposure is mainly to prevent sharp weapon injury and nursing staff is the high risk group within 3 years of work. By establishing and perfecting the HIV protection system, measures, procedures and effective implementation, especially strengthening the protection of high risk groups in HIV patients surgery will effectively reduce the risk of occupational exposure to HIV of primary health care workers.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.91

【参考文献】